Interactive Case Study Companion

Dysplastic glands
Inflamed lamina propria

4 - Esophagus, dysplasia - Medium power  
Critical to the evaluation of patients with Barrett esophagus is the recognition of associated dysplasia, the precursor of malignancy. Dysplasia is recognized by the presence of cytologic and architectural abnormalities. The dysplastic glands resemble adenomatous glands typically seen in adenomatous polyps of the colon. The image shows the metaplastic columnar epithelium completely replaced by dysplastic epithelial cells with enlarged, crowded, and stratified hyperchromatic nuclei. In some areas, the glands are lined by cells that maintain their basal polarity, and in other areas, the glands show cells migrating toward the lumen.  
What is the definition of a Barrett esophagus?


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